A single mutation or translocation is supposed to confer a survival advantage to the respective cells and it is usually isolated, explaining the low tumor mutation burden observed in these tumors [5], leading to less inflamed tumor microenvironments with death of tumor-infiltrating CD8+ lymphocytes, explaining the low response rate to PD-1 inhibitors observed amongst EGFR- and ALK-driven NSCLC [6••]. The gene discussed is ALK; the disease is non-small cell lung carcinoma.